Breakthrough venous thromboembolic events in five patients with COVID-19 on direct oral anticoagulants

Link to article at PubMed

J Clin Pharm Ther. 2020 Nov 20. doi: 10.1111/jcpt.13311. Online ahead of print.


WHAT IS KNOWN AND OBJECTIVE: Coronavirus disease 2019 (COVID-19) is associated with increased risk of venous thromboembolism (VTE). Guidance for VTE prophylaxis continues to evolve, including addressing direct oral anticoagulants (DOACs) continued upon hospitalization.

CASE SUMMARIES: We present 5 patients hospitalized for COVID-19 while on DOACs. Four patients had atrial fibrillation and had a previous VTE. Four patients developed acute VTE and one developed stroke-like symptoms. Monitoring D-dimer assisted with the detection of VTE. Three patients died, and two were discharged alive.

WHAT IS NEW AND CONCLUSION: Therapeutic failure with DOACs appears to be commonplace in COVID-19. Further research is needed to determine whether there is an underlying cause to this association.

PMID:33217032 | DOI:10.1111/jcpt.13311

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